Change of location for work placement (UG and PGT Students)

This form should be used to report a change in location for a Tier 4 student undertaking a work placement. A change of location for a work placement needs to be reported on all occasions, irrespective of its duration. Please note that the student will remain registered at the University for this period and their Tier 4 sponsorship will continue. Appropriate monitoring points should be in place and appropriate records of this kept.
The change of location for a work placement will be reported to the Home Office.

ABOUT YOU

Your Name
*

Department
*

Are you
*

Confirm this request has been approved by the Director of Graduate/Undergraduate Studies or the Head of Department
*

Email address for staff member
*

Phone Number
*

STUDENT DETAILS

Full Name of Student
*

University ID Number
*

Course Name
*

DETAILS OF CHANGE

Start date of work placement
*

Expected Return Date
*

Please provide as many details as possible about the work placement and why the student is changing their location
*

Please provided the full address of the work placement, where the student will be located
*

Agreements (please tick)
*

I understand that the student will remain registered at the University during this period and our Tier 4 sponsorship duties will continue. I therefore confirm that the department has arranged appropriate monitoring points during this period.
I confirm that the student has given their consent to this report being made and understands that the Home Office will be notified of this change.
I understand that it is the department’s responsibility to complete the ‘Change of location for work placement – return to Warwick’ form once the student has returned from a period away from the University.

University ID

User code

Full name

Email

* indicates a required field

Privacy statement

The data collected on this form will be used solely to update the student's record and enable the University to report a change of status to the UKVI.